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Organization
CLARK AND SCHULZE NP PRACTICE
Active
Organization
CLARK AND SCHULZE NP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL CLARK (NP/OPERATING AGENT)
(618) 367-3732
Entity
Organization
Contact information
Practice address
1806 WOODFIELD DR OFC 111, SAVOY, IL 61874-9505
(618) 367-3732
Mailing address
1806 WOODFIELD DR, SAVOY, IL 61874-9505
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427557321
NPI
—
01
—
1972979409
NPI
—
Enumeration date
10/03/2022
Last updated
10/03/2022
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